Implementation mapping for tobacco cessation in a federally qualified health center.

Autor:	Domlyn AM; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, United States., Crowder C; Lincoln Community Health Center, Durham, NC, United States., Eisenson H; Lincoln Community Health Center, Durham, NC, United States.; Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, United States., Pollak KI; Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, United States.; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States.; Duke Cancer Institute, Duke University Health System, Durham, NC, United States., Davis JM; Duke Cancer Institute, Duke University Health System, Durham, NC, United States.; Department of Medicine, Duke University School of Medicine, Durham, NC, United States., Calhoun PS; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, United States.; Duke Cancer Institute, Duke University Health System, Durham, NC, United States.; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States., Wilson SM; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, United States.; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States.; Duke Cancer Institute, Duke University Health System, Durham, NC, United States.; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in public health [Front Public Health] 2022 Sep 02; Vol. 10, pp. 908646. Date of Electronic Publication: 2022 Sep 02 (Print Publication: 2022).
DOI:	10.3389/fpubh.2022.908646
Abstrakt:	Background: Implementation mapping (IM) is a promising five-step method for guiding planning, execution, and maintenance of an innovation. Case examples are valuable for implementation practitioners to understand considerations for applying IM. This pilot study aimed to determine the feasibility of using IM within a federally qualified health center (FQHC) with limited funds and a 1-year timeline. Methods: An urban FQHC partnered with an academic team to employ IM for implementing a computerized strategy of tobacco cessation: the 5A's (Ask, Advise, Assess, Assist, Arrange). Each step of IM was supplemented with theory-driven methods and frameworks. Data collection included surveys and interviews with clinic staff, analyzed via rapid data analysis. Results: Medical assistants and clinicians were identified as primary implementers of the 5A's intervention. Salient determinants of change included the perceived compatibility and relative priority of 5A's. Performance objectives and change objectives were derived to address these determinants, along with a suite of implementation strategies. Despite indicators of adoptability and acceptability of the 5A's, reductions in willingness to adopt the implementation package occurred over time and the intervention was not adopted by the FQHC within the study timeframe. This is likely due to the strain of the COVID-19 pandemic altering health clinic priorities. Conclusions: Administratively, the five IM steps are feasible to conduct with FQHC staff within 1 year. However, this study did not obtain its intended outcomes. Lessons learned include the importance of re-assessing barriers over time and ensuring a longer timeframe to observe implementation outcomes. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Domlyn, Crowder, Eisenson, Pollak, Davis, Calhoun and Wilson.)
Databáze:	MEDLINE
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